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Individual

KARA LEE MAUCIERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 545-4456
Mailing address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 545-4456

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38856
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0116180
MEDICA
01
080006801
MEDICARE
01
080122966
RR MEDICARE
01
112865C750
UCARE
05
246823900
MN
01
50Q23MA
BCBS
01
779799
AMERICAS PPO
01
7884035
AETNA
01
E007
TRICARE
01
HP26005
HEALTHPARTNERS
01
NS1141016489
PREFERRED ONE
Enumeration date
12/05/2005
Last updated
11/19/2020
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